Keeping It Together – Even When You Don’t Want To

I received some sad news this morning. A former client passed away over the weekend and the funeral is tomorrow. They left the agency several months ago because they needed a higher level of care. This is the second former client who has died in the last 30 days. Losing clients (even if they’re former, you will always think of them as your client) is never easy. As a social worker I’m privileged to be involved in intimate details of people’s lives. I wouldn’t be in this line of work if I didn’t care deeply about those I work with. A professional hazard is that you will inevitably lose each client – many will recover and move on (YAY), some will drop out and you’ll never hear from them again, and some will die before their time.

I work with individuals diagnosed with serious mental illness. They are vulnerable to homelessness, abuse, poverty, lack of access to nutritious food, unhealthy lifestyle habits (smoking, lack of exercise due to illness or because of fatigue from medications), etc. People with these diagnoses tend to die about 25 years sooner than the general population. This means that the death of a client in their 40s or 50s is not unusual.

One of the things that has made the deaths of the two clients this month so difficult is that I needed to support my staff and other clients with the grieving process while I also grieve. Today was a difficult day. First stop this morning was to tell the other clients and answer their questions to help them start to process their grief. The next job was notifying all the staff who worked with this person and supporting any of them who needed to talk. In addition, there was my regular workload. All of this had to happen while I was feeling quite sad and somewhat guilty that I hadn’t followed up with the former resident and visited them in the nursing home the way I intended.

I think that all of us, at some point in our daily lives, have needed to keep our own reactions in check in order to make sure thing get taken care of. Sometimes this must be done daily. So how do we keep it together when all we want to do is fall apart? Here are my suggestions:

Acknowledge your feelings – To the best of your ability in your situation acknowledge that you’re not feeling 100%. Depending on what’s been going on, a simple “I’m not at my best today” may be helpful. If you don’t feel comfortable saying this in your work environment then at least acknowledge it to yourself. Give yourself a break if you find that you’re not working as quickly or as accurately as usual. We all have off days. You are human, you’re allowed to not be perfect.

Talk it out – If you have someone you trust at work then go to them and ask if you can share some of your thoughts. Be mindful when choosing who to help you process thoughts or feeling. For example, I wouldn’t go to one of the staff I supervised to talk about feeling sad at the loss of this client because I’m supposed to be the one supporting them. I’m honest with staff about my feelings – I can tell them that I feel sad about the death of the former client but for a deeper exploration of my feelings I seek out either a supervisor or someone else in the company that I don’t supervise.

Set aside time to fully experience your emotions – I learned this from a former supervisor who specialized in treating other therapists. It is very useful when sitting with a client who is sharing tragic or horrifying personal details. If you’re in a situation where you can’t react the way you really want to (cry, scream, curse), then make yourself a promise. Identify a time later that day when you can react the way you want to and tell yourself that you can put those thoughts and feelings on hold until that time. The trick to this is that when the identified time comes, you MUST keep the promise you made to yourself and allow yourself to think whatever sad, negative, irrational thoughts that you ignored earlier. If you promise yourself a time to react, put your feelings on hold, and later don’t give yourself what you promised then you stifle your emotions which will impede healing or coping with whatever is going on. I find this one helpful when I have intrusive sad or anxious thoughts that are keeping me from doing my work. Once I tell myself I’m going to deal with those thoughts later in the day I’m able to refocus on what I need to do.

Take care of yourself – When you are struggling it is crucial to take good physical care of yourself. Your mind is already going through a lot, don’t make it also have to deal with a body that feels unhealthy. You may have the urge to eat ¾ of the birthday cake in the break room left over from yesterday’s celebration (been there, done that), but try to keep yourself to a regular-sized piece. Drink lots of water and minimize your caffeine intake. If possible, take a short walk during a lunch break. Eat whole fruits and vegetables. Try doing some gentle stretching.

As always, some (or none!) of my suggestions may be helpful or effective in your situation. I can only share the things that help me. I would love to hear ways other people make it through their day when it’s an extra struggle?

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Published by Liz

I'm a licensed clinical social worker and a supervisor in a non-profit agency. I'm also a full-time student pursuing my doctorate in social work. When I'm not working or studying I spend time with my friends and family (both the furry and human kind) or curled up with a good book.
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